Se estima que afecta entre el 8 y el 12% de las parejas en edad reproductiva en todo el mundo. Se encuentra que los hombres son los únicos responsables del 20-30% de los casos de infertilidad, pero contribuyen al 50% de los casos en general.

Los problemas de fertilidad se presentan cada vez con más frecuencia en la población, cada cuatro parejas en los países en desarrollo pueden estar afectadas. Hay muchos motivos sociales que llevan a las parejas a tener menos hijos y más tarde, es necesario identificar el momento indicado para consultar a un especialista, así como los diferentes factores que podrían influir para conseguir la concepción.

En este apartado desarrollamos el concepto de infertilidad, los factores que pueden influir en este, y que tener en cuenta, al momento de elegir tener un hijo, para mejorar tu fertilidad.

¿Qué es la fertilidad y la infertilidad?

La fertilidad hace referencia a la capacidad que tiene un hombre o una mujer para reproducirse.

La infertilidad definida por la OMS en la Clasificación Internacional de Enfermedades (CIE-11) es “una enfermedad del sistema reproductivo definida por la imposibilidad de lograr un embarazo clínico después de 12 meses o más de relaciones sexuales regulares sin protección” en otras palabas, es la incapacidad de completar un embarazo después de un tiempo razonable  de  relaciones  sexuales, sin  medidas anticonceptivas.

Muchas veces suele confundirse con “esterilidad”, que es la dificultad de lograr un embarazo por medios naturales, o con “subfertilidad” donde existe la posibilidad pero el embarazo no ocurre.

Como podemos ver, la definición incluye un tiempo, “tiempo razonable”, después del cual una pareja y/o los profesionales deberían considerar como orientativo para pensar en problemas de fertilidad, junto con otras características. Por ejemplo, en una mujer de 39 años, podría ser aconsejable comenzar los estudios transcurridos los primeros seis meses.

¿Cuáles son las causas más frecuentes de infertilidad?

Podemos decir que la fertilidad es multifactorial. Para explicar los diversos factores que producen la infertilidad podemos distinguir entre los dos sexos:

-El desarrollo de la infertilidad femenina puede verse causada por:

  • Infertilidad anovulatoria
  • Hiperprolactinemia
  • Hipogonadismo hipogonadotrópico e hipergonadotrópico
  • Ovarios poliquísticos
  • Infertilidad tubárica-peritoneal:
  • Endometriosis
  • Infertilidad uterina
  • Migración alterada de los espermatozoides
  • Infertilidad quirúrgica y hormonal

-En cuanto a la infertilidad masculina las causas son:

  • Varicocele
  • Disfunción eyaculatoria
  • Oligospermia
  • Azoospermia
  • Anormalidades en los espermatozoides
  • Anormalidad del semen
  • Factor endocrino e inmunológico
  • Gonadotoxinas por diversos agentes ambientales

La exposición a factores ambientales también tiene relevancia para la infertilidad:

  • Campos electromagnéticos y la irradiación: ha sido demostrada que la radiación ejerce efectos adversos tanto en hombres como mujeres ya que afecta a células germinales.
  • Calor: altas temperaturas puede producir daños en el ADN espermático.
  • Contaminación del aire: muchos de los contaminantes que podemos encontrar en el aire serían el monóxido de carbono, emisiones industriales, dióxido de nitrógeno.
  • Exposición a solventes y pesticidas: se ha visto que los hombres trabajadores en agricultura que están en contacto con pesticidas han tenido una reducción en la concentración espermática.
  • Exposición a metales pesados: el plomo y mercurio han sido los dos más estudiados.

Consejos para mejorar la fertilidad

Hay algunos consejos para lograr mejorar la fertilidad que pueden aplicarse tanto al hombre, como a la mujer y que van a ayudarte a estar más preparado/a para conseguir un embarazo, además de traerte mejor salud en general:

  • Lleva una dieta sana y equilibrada: elige alimentos ricos en antioxidantes y vitaminas, como las verduras y las frutas, alimentos con ácido fólico (espinacas) y omega 3.
  • Controla tu peso: la obesidad puede afectar negativamente a la ovulación o a la calidad de los espermatozoides, además de conllevar mayor riesgo de complicaciones durante el embarazo y el parto. Pero también estar por debajo del peso ideal puede traer complicaciones.
  • Evitad el tabaco ambos miembros de la pareja, así como moderación en el consumo de alcohol. Afectando a la producción, la motilidad y morfología de los espermatozoides y a ellas dañando el microambiente folicular y con alteración de los niveles hormonales en la fase lútea.
  • Practica deporte con frecuencia: previene la obesidad y reduce el estrés, lo que ayuda por partida doble a la salud reproductiva. Existe una disminución del riesgo de infertilidad en la fase ovulatoria con la práctica del ejercicio.
  • Fuera el estrés y la ansiedad: Practica meditación o yoga para relajarte, y realiza actividades tranquilas en pareja que ayuden a tomar el asunto con calma.
  • Evitar tener relaciones sexuales sin utilizar protección, así evitamos las enfermedades de transmisión sexual que pueden producir infertilidad en el futuro.
  • Acude a un especialista: si llevan demasiado tiempo, siempre pueden acudir al médico de familia para iniciar un estudio de fertilidad. Esto no quiere decir que exista algún problema, pero siempre es mejor estar informados de todos los aspectos que pueden estar influyendo.

Como conclusión podemos decir que es importante proponer  a las parejas la modificación del estilo de vida, así como considera la exposición de tóxicos ambientales.

El equipo de salud debe tener presente que existen los diferentes problemas que influyen en la fertilidad y que es conveniente realizar interconsultas con los especialistas para considerar y no retrasar el inicio del tratamiento.

Para las personas con dificultades reproductivas es fundamental saber que ningún tratamiento asegura el embarazo para que no lo perciban como una salida “mágica”. Es indispensable transmitir que si bien se espera que salga bien, existe también la posibilidad de que no resulte, o que se requiera más de un tratamiento hasta lograr el resultado deseado.

Fuente:

OMS – Multiples definiciones de Infertilidad, Febrero 2020. (  Click Aqui)

Brugo-Olmedo S., Chillik C., Kopelman S – Definicion y causas de infertilidad, 2003 (Click Aqui)

Generoso-Marroquino, M. – Causas, factores predisponentes y consecuencias de la infertilidad sobre la pareja, 2016. (Click Aqui)

Mélodie Vander Borght,  Christine Wyns. – Fertilidad e infertilidad: definición y epidemiología, 2018. (Click Aqui)

Programa Nacional de Salud Sexual y Procreación Responsable – Guía sobre fertilidad para equipos de atención primaria de la salud, 2015. (Click Aqui)


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